The following is a message from International Community Health Services.

There is a silent killer that disproportionately effects one in 12 Asian Americans and other immigrants. It is the leading cause of liver cancer, easily passed from pregnant mother to child and stealthily assaults entire families. Yet because there are often no symptoms, two out of three people with chronic hepatitis are unaware of the health risk they carry.

This hidden epidemic is caused by the hepatitis B virus. A disease causing inflammation of the liver, acute hepatitis B may or may not make a person sick with flu-like symptoms before they feel better. For Asian Americans, the risk for developing chronic hepatitis is high because many are infected as infants. Without proper screening and diagnosis, chronic hepatitis B is a ticking time bomb—an apparently healthy body can be infected for years—even decades. Left untreated, it can lead to cirrhosis, liver damage, liver failure, or liver cancer.

Chia Wang MD, a leading expert on infectious diseases and a hepatitis specialty provider at International Community Health Services (ICHS), describes a problem that reaches deep into Seattle’s Asian American and immigrant communities.

“Though they only make up 5% of the total U.S. population, Asian Americans, Native Hawaiians, and Pacific Islanders account for half of Americans living with chronic hepatitis B infection. Likewise, people from sub-Saharan Africa are also at a higher risk,” she said. “Because they experience more barriers to care, those in the immigrant community can be difficult to reach and are less likely to be diagnosed.”

Wang outlined the importance of breaking the silence. “Hepatitis B gets shoved under the rug by the very communities it impacts because of misperceptions, shame, and fear,” she said. “The lack of discussion can be deadly and needs to change. We must remove the stigma so people start talking.”

A first step is clearing up some common myths.

Chia Wang, MD is an infectious diseases doctor who has worked at ICHS since 1999, seeing patients with chronic hepatitis B and C. She has been principal investigator on multiple grants focusing on the treatment and transmission of viral hepatitis, as well as on an NIH-funded ICHS project studying the use of health information technology to improve the care of hepatitis B patients. • Courtesy Photo

Myth No. 1: Hepatitis B causes easy-to-identify symptoms

Most people do not experience any symptoms during the acute infection phase, although some may experience yellowing of the skin and eyes, dark urine, fatigue, nausea, vomiting and abdominal pain. After initial infection some people will naturally clear the virus from their body, while others will go on to develop a long-term, or chronic, condition.

Myth No. 2: People without symptoms are “healthy carriers”

People with chronic hepatitis B can otherwise appear active and healthy. The quiet nature of the disease is misleading as the more serious consequences are often irreversible by the time they are obvious. Getting screened through a simple blood test, and getting treatment as recommended by a doctor is essential to long-term health and survival.

Myth No. 3: Hepatitis B is caused by poor hygiene

Hepatitis B is not contracted from dirt or poor hygiene. It cannot be passed from food, utensils, or casual contact like hugging and kissing. Hepatitis B is passed from one person to another through blood or bodily fluids. While it can be contracted through sexual activity or shared needles, most immigrants with chronic hepatitis B are infected at birth or as an infant.

Myth No. 4: My doctor already did blood tests with me, I must not have it.

“Tests for chronic hepatitis B are not routine tests, and if you or your parents are immigrants from Asia, as well as Africa, Eastern Europe, and the Pacific Islands, you should ask your doctor to con rm that you have been screened,” said Wang.

Myth No. 5: We are already vaccinated so we don’t need to worry

There is a highly effective hepatitis B vaccine that most children in the United States receive as infants. However, depending on when and where a person or their children are born, they may still be at risk. The vaccine prevents infection but if does not offer a cure or protection to those that already carry it.

May is Hepatitis Awareness Month

“Asian American and immigrant communities need to start opening up, and start doing it now,” said Wang.

“The month of May is dedicated to hepatitis awareness, prevention, and screening. Celebrate it with three easy actions that may save your life or that of a loved one,” she said. “First, if you don’t know your chronic hepatitis B status, get screened by your doctor. Second, if you are not infected and not immune, ask your doctor for the hepatitis B vaccine. It is one of the few cancer-causing viral infections that can be prevented by a vaccine. And finally, a great way to gain some understanding about the problem and how it’s been allowed to persist among our minority communities is to go see Be About It.”

A new documentary that explores key issues through the story of two families living with hepatitis B, Be About It, is produced by Christopher Wong, a former ABC anchor who is, himself, a chronic carrier. Both of the Asian American men featured in the lm contracted the virus at birth. Each struggled with the consequences of silence and misunderstanding in their own way.

Sponsored by ICHS and the Hepatitis B Coalition of Washington, the Seattle premiere is free to the public and includes a community forum and discussion at the New Holly Gathering Hall on May 23, from 5:00 p.m. to 8:30 p.m.

ICHS offers hepatitis B screenings at its clinic locations in Chinatown-International District, Holly Park, Shoreline, and Bellevue. ICHS accepts most major insurance coverage plans, including Medicare and Medicaid, and turns no one away, regardless of ability to pay. There is a sliding fee scale for those who qualify.

About ICHS

Founded in 1973, ICHS is a non-profit community health center offering affordable primary medical and dental care, acupuncture, laboratory, pharmacy, behavioral health WIC, and health education services. ICHS’ four full-service medical and dental clinics— located in Seattle’s International District and Holly Park neighborhoods; and in the cities of Bellevue and Shoreline—serve nearly 29,000 patients each year. As the only community health center in Washington primarily serving Asians and Pacific Islanders, ICHS provides care in over 50 languages and dialects annually. ICHS is committed to improving the health of medically-underserved communities by providing affordable and in-language health care. For more information, please visit:

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